Urogenital complications of pelvic trauma: a report on 48 cases from Douala (Cameroon)

Abstract

Objectives: Describe the epidemiological, clinical and therapeutic aspects of urogenital complications associated with pelvic trauma in the Laquintinie Hospital of Douala.

Materials and Methods: This was a descriptive retrospective study involving all cases of urogenital complications of pelvic trauma in the Departments of Urology and Orthopaedic surgery of the Douala Laquintinie Hospital. It covered a period of six years nine months (2011 – 2016). Tile’s classification was used to classify pelvic fractures.

Results: A total of 48 (38.71%) patients with complications of pelvic trauma were selected out of the 124 cases with pelvic fractures. Males were more involved with a sex ratio of 5, and the mean age was 33 years (range 20 – 55 years). The presenting symptom was essentially haemorrhage [haematuria and urethrorrhagia (35.44%)], and pelvic and/or perineal pain (30.95%). Tile B fractures were the most frequent. Posterior urethra lesions were the most common urinary complications observed (45.84%). Emergency management was done on a case-by-case basis: surveillance, urethral catheterization, exploratory laparotomy or diverting cystostomy. Seventeen cases were deferred on which end-to-end anastomotic urethroplasty was performed for urethral rupture. As a functional outcome, 6 patients developed dysuria requiring urethral dilatation, and 4 complained of erectile dysfunction after a follow-up of 24 months.

Conclusion: Urogenital complications of pelvic trauma are common in the Douala Laquintinie Hospital. Their gravity depends on the degree of instability of the fractures (Tile B and C). They are responsible for important sexual and urinary sequelae. Training of nonsurgical medical personnel would ensure proper initial management of the patient before any specialised multidisciplinary treatment.